踝关节隐匿性损伤的MRI表现

The MRI Features of the occult fracture of ankle

目的 探讨踝关节隐匿性骨折MRI表现。方法 回顾性分析17例有明确外伤史 ,X线表现为阴性、MRI表现阳性的病例。使用Siemensvision-plus1.5T超导高场MRI系统成像。常规SE序列T1W成像 (TR/TE=700/20)、FSE序列WI(TR/TE=4700/100)和T2WI脂肪抑制 (FS)序列。结果 17例有9例表现关节软骨不规则缺失 ;7例有软骨下骨小梁骨折 ;13例患者共有16处骨髓片状异常信号 ,10处为T1低信号T2高信号 ,6处为T1低信号T2混杂信号 ,脂肪抑制序列表现为明显高或混杂偏高信号 ;其中4例伴有关节腔积液、1例有踝关节外侧韧带损伤。结论 MRI是发现踝关节隐匿性损伤的有效检查技术 ,表现包括关节表面软骨缺失、软骨下皮质骨骨折。

Objective To study the MRI Features of the occult fracture of ankles. Methods 17patients who all had definitely traumatic history of ankle joint,negative results of plain radiographs,serious pain in local traumatic ankle and positive MRI features were retrospectively analysed.Siemens1.5TMRI with SE and FSE were used to investigate the ankle T1WI(TR/TE=700/20),T2WI(TR/TE=4700/100)and T2WI fat-suppression(FS). Results MRI features in9of17cases manifested irregular deficits of articular cartilage of ankle,7cases were bone trabecula fractures under cartilage.13cases manifested abnormalities of bone marrowwith hypointensity on T1WI and hyperintensity on T2WI,6cases with hypointensity on T1WI and complex signal intensity on T2WI,There were fluid in4articular cavity and2cases with lateral ligament injury. Conclusion MRI features were of important value in diagnosis of occult fracture of ankle joint including articular cartilage surface deficits,cortical bone fracture under the articular surface,trabecular fracture under cortical bone and edema or bleeding in the trabecular bone which demonstrated irregular abnormal signal.